{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T02:06:55Z","timestamp":1774490815435,"version":"3.50.1"},"reference-count":71,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T00:00:00Z","timestamp":1676505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:p><jats:italic>Streptococcus pneumoniae<\/jats:italic> causes significant morbidity and mortality among older adults. Detection of pneumococcal carriage is an accepted endpoint in pneumococcal conjugate vaccine studies. However, low sensitivity of culture-based approaches and nasopharyngeal samples have hampered adult <jats:italic>S. pneumoniae<\/jats:italic> carriage studies in the past. In contrast, detection of adult <jats:italic>S. pneumoniae<\/jats:italic> carriers with qPCR-based approaches can achieve high sensitivity and specificity and qPCR-based testing of oral samples improves accuracy of adult carriage detection. In this Viewpoint we outline a strategy for accurate qPCR-based testing. We recommend a dual-target approach for <jats:italic>S. pneumoniae<\/jats:italic> qPCR detection as no genetic target is universally present among or solely unique to it. Furthermore, we advise the evaluation of concordance among quantified qPCR targets to improve the accuracy of <jats:italic>S. pneumoniae<\/jats:italic> testing and qPCR-based serotyping. We do not recommend omission of qPCR-based oral sample testing as it will likely result in an underestimation of true adult carrier rates.<\/jats:p>","DOI":"10.3389\/fmicb.2023.1122276","type":"journal-article","created":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T12:41:07Z","timestamp":1676551267000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":27,"title":["Streptococcus pneumoniae carriage studies in adults: Importance, challenges, and key issues to consider when using quantitative PCR-based approaches"],"prefix":"10.3389","volume":"14","author":[{"given":"Willem R.","family":"Miellet","sequence":"first","affiliation":[]},{"given":"S\u00f3nia T.","family":"Almeida","sequence":"additional","affiliation":[]},{"given":"Krzysztof","family":"Trzci\u0144ski","sequence":"additional","affiliation":[]},{"given":"Raquel","family":"S\u00e1-Le\u00e3o","sequence":"additional","affiliation":[]}],"member":"1965","published-online":{"date-parts":[[2023,2,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"E90974","DOI":"10.1371\/journal.pone.0090974","article-title":"Low prevalence of pneumococcal carriage and high serotype and genotype diversity among adults over 60 years of age living in Portugal","volume":"9","author":"Almeida","year":"2014","journal-title":"PLoS One"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1590","DOI":"10.1093\/infdis\/jiaa558","article-title":"Dynamics of pneumococcal carriage in adults: a new look at an old paradigm","volume":"223","author":"Almeida","year":"2021","journal-title":"J. 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